Learn about zygoma reduction, a plastic surgery procedure to create a slimmer facial profile by reducing prominent cheekbones.

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What is Zygoma Reduction Surgery?

Zygoma reduction, also known as cheekbone reduction surgery, is a cosmetic surgical procedure that reduces the size and projection of the zygomatic bones, or cheekbones. This procedure is a type of facial contouring surgery that aims to create a narrower, more slender, and balanced facial appearance. A plastic surgeon who specialises in craniofacial procedures performs this surgery to address concerns about overly wide or prominent cheekbones that may make the face appear disproportionate or harsh.

The goal of zygoma reduction is to refine the mid-face architecture for improved harmony and a softer overall aesthetic. By carefully repositioning or shaving down the bone, the surgeon can achieve a significant yet natural-looking transformation that aligns with the patient’s desired facial shape.

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The Etymology of Zygoma

Zygoma (Cheekbone) Reduction

The term “Zygoma” has its roots in the Greek language:

  • ‘Zygon’ (Greek): Meaning “yoke” or “junction.” This refers to how the cheekbone connects different parts of the skull.
  • ‘Oma’ (Greek suffix): Often used in anatomy to denote a structure or feature.

Together, “zygoma” refers to the bone that forms the prominence of the cheek and bridges the temporal bone with the maxilla (upper jaw). Understanding this anatomical anchor point is key to appreciating how its modification can reshape the entire face.

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Causes and Risk Factors (Reasons for Seeking Surgery)

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Zygoma reduction is a specialised procedure that focuses on altering the facial skeleton to achieve a cosmetic goal. It is often sought by individuals who feel their face is too wide or their cheekbones are overly pronounced, which can be a result of genetics.

The surgeon’s role includes:

  • Facial Analysis and Planning: Assessing the patient’s facial structure, bone density, and aesthetic goals to create a precise surgical plan.
  • Surgical Execution: Performing the bone reduction through techniques like shaving, burring, or osteotomy (cutting and repositioning the bone).
  • Achieving Facial Harmony: Ensuring the new cheekbone shape complements the nose, chin, and jawline for a balanced and attractive result.
  • Post-operative Care: Guiding the patient through the recovery process to ensure optimal healing and outcomes.

What Zygoma Reduction Is Not About

It’s important to differentiate zygoma reduction from other facial procedures. This surgery specifically targets the bone structure of the cheeks. It is not a solution for chubby cheeks caused by excess soft tissue or buccal fat; for that, a buccal fat removal procedure might be more appropriate.

While a zygoma reduction can create a slimmer facial profile, it does not address sagging skin or signs of ageing. In some cases, it may be combined with a facelift or other procedures for a more comprehensive facial rejuvenation, but its primary purpose is skeletal reshaping, not skin tightening.

The Role of Balanced Facial Features

A central goal in facial plastic surgery is achieving harmony and proportion. The cheekbones are a critical component of facial aesthetics, defining the contours of the mid-face.

Well-proportioned cheekbones contribute to:

  • Defining Facial Shape: They create the classic “oval” or “heart” shape often associated with youth and beauty.
  • Providing Structural Support: They support the soft tissues of the mid-face, preventing premature sagging.
  • Creating Aesthetic Highlights: They catch light in a way that adds dimension and character to the face.

Main Surgical Techniques Covered

Surgeons use several methods to perform zygoma reduction, tailoring the approach to the patient’s anatomy and desired outcome.

  • Shaving or Burring: For minor reductions, the surgeon can shave down the front surface of the zygomatic arch. This is less invasive but provides limited results.
  • Inward Fracture Osteotomy (L-Shape): This is the most common technique. The surgeon makes precise cuts in the zygomatic bone (an L-shaped osteotomy), allowing the prominent section to be moved inward and repositioned. It is secured with small titanium plates and screws.
  • Malarplasty Rotation: In some cases, the cheekbone can be rotated to reduce its forward projection while maintaining a natural curve. This is effective for reducing both width and frontal prominence.

Related Facial Structures in Focus

Although the surgery focuses on the cheekbones, it impacts the entire facial aesthetic by altering its proportions. Key related structures include:

  • The Mandible (Jawbone): The width of the cheeks should be in harmony with the width of the jawline. Surgeons often consider jawline contouring (genioplasty or jaw reduction) in conjunction with zygoma reduction.
  • The Nose: The prominence of the cheeks affects the perceived size and shape of the nose.
  • The Eyes: Reducing cheekbone projection can subtly alter the appearance of the under-eye area.

Tracking Surgical Outcomes

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One of the most important elements of zygoma reduction is a thorough pre-operative assessment. Modern imaging technologies help surgeons plan and execute the procedure with high precision.

Surgeons use these tools to:

  • Create 3D Models: CT scans are used to create a three-dimensional model of the patient’s skull for precise surgical planning.
  • Simulate Results: Virtual simulations can help patients visualise the potential outcome and align expectations with the surgeon.
  • Assess Asymmetry: Identify and plan corrections for any pre-existing facial asymmetry.

Position and Importance in Cosmetic Surgery

Zygoma reduction is a highly effective and transformative procedure within the field of facial contouring. It has gained popularity worldwide, particularly in East Asia, where a slimmer, more ovoid facial shape is often considered aesthetically ideal. Its importance lies in its ability to create profound changes in facial harmony that cannot be achieved through non-surgical means.

Why zygoma reduction matters:

  • It offers a permanent solution for individuals concerned about facial width.
  • It empowers patients to achieve a facial appearance that better aligns with their self-image.
  • It showcases advanced surgical techniques that allow for precise, predictable, and safe skeletal modification.

Zygoma Reduction Sub-specialities

Key considerations in this speciality include:

  • Revision Zygoma Surgery: Correcting or improving the results of a previous cheekbone reduction.
  • Combined Facial Contouring: Performing zygoma reduction along with other procedures like V-line jaw surgery or genioplasty for a total facial makeover.
  • Reconstructive Surgery: Applying zygoma reduction principles to correct facial deformities resulting from trauma or congenital conditions.

Zygoma reduction is a powerful procedure that helps refine facial aesthetics by creating a more slender and balanced silhouette. By modifying the underlying bone structure, it offers a lasting solution for achieving desired facial contours.

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FREQUENTLY ASKED QUESTIONS

What is zygoma reduction, and who is a good candidate for it?

Zygoma reduction is a plastic surgery procedure that reduces the size or projection of the cheekbones to create a slimmer face. A good candidate is a healthy individual who is bothered by overly wide or prominent cheekbones, has realistic expectations, and does not have underlying medical conditions that would impair healing.

Recovery typically involves swelling, bruising, and some discomfort for the first 1-2 weeks. Patients are usually advised to eat a soft diet and avoid strenuous activity for about a month. Most of the major swelling subsides within a few weeks, but final results can take 6 months to a year to become fully visible as minor swelling resolves.

The surgery is performed under general anaesthesia, so you will not feel any pain during the procedure. Post-operative pain is managed with prescribed medication and is usually most significant in the first few days after surgery. Most patients report discomfort and pressure rather than severe pain.

Like any surgery, risks include infection, bleeding, and adverse reactions to anaesthesia. Specific risks for zygoma reduction include nerve damage (leading to temporary or permanent numbness), asymmetry, non-union of the bone (where the cut bone doesn’t heal properly), and cheek sagging. Choosing a highly experienced, board-certified surgeon minimises these risks.

Zygoma reduction alters the facial skeleton by shaving or repositioning the cheekbones to narrow the mid-face. In contrast, buccal fat removal targets soft tissue by removing the fat pads in the hollows of the cheeks. Zygoma reduction addresses facial width caused by bone, while buccal fat removal addresses chubbiness caused by fat.

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